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New Horizons in Patient Directed Exchange
Session 180, February 13, 2019
Teresa Rivera, President and CEO, UHIN
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Teresa Rivera, MBA
Has no real or apparent conflicts of interest to report.
Conflict of Interest
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1. Overview of engagement and patient-directed
exchange
• Importance and overall landscape
2. Discuss some of the issues facing data access and
exchange
3. Review UHIN’s patient portal
4. Call to Action
5. Questions
Agenda
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• State the value to patients and providers of effective patient-
directed exchange
• Describe the purpose and goals of patient applications to
achieve improved health outcomes
• Identify the core application elements that contribute to
increased patient-provider engagement
Learning Objectives
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Who is UHIN?
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Convener of the Community
UHIN
Payers
Providers
State
Government
Patients
Hospitals
Involvement of
all Stakeholders
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Studies show engaged patients more likely to have:
Engaged Patients are Healthy Patients
Checkups
Screenings
Immunizations
Healthier
eating/exercise
behavior
Lower likelihood
of smoking /
illegal drug use
Better
adherence to
care plans
Regular chronic
condition care
Lower BMI
Cholesterol
Hemoglobin A1c
blood pressure
Source: HealthAffairs, Feb. 2013
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Scripps Health estimates it realizes $25 per patient
• Fewer phone calls
• Better routing of messages
Ohio State University study found significant savings
• Nearly $90 per patient
• Over $171,000 for approximately 2,000 patients
Patient Usage of Their Data Leads to Financial
Efficiencies for Payers & Providers
Source: Modern Healthcare, Nov. 24, 2018
Paperless Billing
Saved $2.5 Million annually
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MACRA & MIPS requirements include:
• Patients access to information
• Patient – Provider communications
Patient Access to their Data
ONC suggests engagement leads to:
• Better patient-centered care
• Improved outcomes
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• Patient does not stay within one
health system
• Providers need all information
for accurate diagnosis and
treatment
• Not all providers are connected
to an HIE (but should be!)
Need for Exchange of Patient Information
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• Increasingly seen as
mechanism to improve
patient engagement
• Patients want larger
decision-making role in their
care
• Greater use of technology to
track healthcare data
• Important move into market
by non-health care
companies
Patient-Directed Exchange
Health Plans
Offering Tools
Consumers
who know
about them
98%
30%
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• Open APIs allow for patient-directed exchange with
third-party apps
• Apple’s Health is leading the way
Changing EHR Technology
• Others eyeing the space:
Microsoft
Amazon
Facebook
Google
Source: CARIN Alliance / Leavitt Partners
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• Giving patients access to their Medicare claims
• CMS pushing to have commercial do the same
CMS Blue Button Initiative
The Blue Button symbol signifies that a site has
functionality for customers to download health
records. Patients can use this health data to
improve their health and to have more control
over their personal health information and
their family’s healthcare.
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The CARIN Alliance
• The CARIN Alliance: a non-partisan, multi-sector alliance
• Vision: Rapidly advance the ability for consumers and
their authorized caregivers to easily get, use, and share
their digital health information when, where, and how
they want to achieve their goals using APIs.
Enabling consumers and their authorized caregivers to
access more of their digital health information with less
friction.
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The CARIN Alliance
“We envision a future where any consumer can choose any
application to retrieve both their complete health record and
their complete coverage information from any provider or
plan in the country.”
Definition: Consumer-directed exchange occurs when a
consumer or an authorized caregiver invokes their HIPAA
Individual Right of Access (45 CFR § 164.524) and requests
their digital health information from a HIPAA covered entity
via an application or other third-party data steward.
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• Patients are tired of multiple portals
• Portals do not aggregate data over disparate providers
(i.e. Apple)
• HIEs perform patient matching to ensure longitudinal
record
Why a Patient Portal in the HIE?
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UHIN’s patient portal
• Aggregates data from all data sources
in the HIE
Part of ONC interoperability grant
• Built internally
Creation of MYONECHART
Initial users included:
• 2 employer groups
• Graduate students at Utah Valley
University
Mobile version also available
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MYONECHART Current Capabilities
Access to all records
found in the HIE
Includes Open Notes
from participating organizations
Securely exchange records and
communicate with provider
Allows for greater transparency
Facilitates patient-provider
discussions
Permits greater
patient-directed exchange
Can attach CCD
Using Direct Secure Messaging -
SES
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MYONECHART demo
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• Parental proxy access
• CYSHN-kids with multiple co-
morbidities
• May need to continue through
adulthood
• Patient/Caregiver Education and
Engagement Resources
• Curated succinct CCD of relevant
information
MYONECHART Next Steps
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• Insurance Benefit information
• Out of pocket accumulation (i.e. Co-
pays and Deductibles)
• Physician’s Orders for Life-
Sustaining Treatment (POLST)
• Access to Care Plans
• Notifications of admissions to
Caregivers
MYONECHART Longer-Term Upgrades
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Check information,
including medication list,
for accuracy
What Should Patients Do With Their Records?
Keep track of child’s
last vaccination
Share with their doctor,
trusted family members
or caregivers
Plug health information into
apps and tools that help set
and reach personalized
health goals
Have medical history available
in case of emergency, when
traveling, seeking 2
nd
opinion,
or switching health plans
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• Resolving patient matching issues
• Active participation in developing and
following the Care Plan
• Allowing the Caregiver to access
information quickly on behalf of the
patient
Additional Benefits of Patient Portals
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Call to Action
PROVIDERS
Ensure your EHR system
provides an API for the patient to
access their records
PAYERS
Create a blue button API
Allow the patient access to their
claims
PATIENTS
Sign up for access to available
portals – Use your data
HIEs
Add a patient portal to allow patients
access to an aggregated record
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QUESTIONS
Teresa Rivera | trivera@uhin.org
